Organization
ADULT GERIATRIC HEALTH NP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIA MAXIMOVSKY NP (OWNER)
(347) 377-1979
Entity
Organization
Contact information
Practice address
11 RALPH PL STE 112, STATEN ISLAND, NY 10304-4408
(347) 377-1979
Mailing address
11 RALPH PL STE 112, STATEN ISLAND, NY 10304-4408
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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